Active NPI
Benjamin Tyler Wood, PH.D.
- Health Service Psychologist
- Somerville, MA
National Provider Identifier
1669859120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- 10107
- Practice address
- 240 Elm St FL 23
Somerville, MA 02144-2935 - Phone
- (413) 242-6589
- NPI assigned
- May 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3343 | OR | |
| Health Service Psychologist | 103TH0100X | 10107 | MA | Primary |
Addresses
Primary practice location
240 Elm St FL 23
Somerville, MA 02144-2935
Mailing address
40 Mayo St
Belfast, ME 04915-6052
Phone (413) 242-6589
Other practice location 1
131 Housatonic St
Lenox, MA 01240-2513
Phone (205) 535-9295
Other practice location 2
105 The Knolls
Williamstown, MA 01267
Phone (413) 597-2206
Other practice location 3
17 Housatonic St
Lenox, MA 01240-2519
Phone (205) 535-9295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10107 | MA | MD | Mental Health Counselor |
| 3343 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1669859120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 MAYO ST",
"city": "BELFAST",
"state": "ME",
"postal_code": "049156052",
"telephone_number": "413-242-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 ELM ST FL 23",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442935",
"telephone_number": "413-242-6589"
}
],
"practiceLocations": [
{
"address_1": "131 Housatonic St",
"address_purpose": "LOCATION",
"city": "Lenox",
"state": "MA",
"postal_code": "012402513",
"country_code": "US",
"telephone_number": "205-535-9295",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 The Knolls",
"address_purpose": "LOCATION",
"city": "Williamstown",
"state": "MA",
"postal_code": "01267",
"country_code": "US",
"telephone_number": "413-597-2206",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17 Housatonic St",
"address_purpose": "LOCATION",
"city": "Lenox",
"state": "MA",
"postal_code": "012402519",
"country_code": "US",
"telephone_number": "205-535-9295",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOD",
"first_name": "BENJAMIN",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-04",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "3343",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MA",
"license": "10107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.